Thursday, July 16, 2009

Fertility Treatments: Not a black and white issue.

The (at the time) oldest mom in America died this week.

She was 67 years old when she gave birth to twin boys. Boys conceived, obviously, through fertility treatments. IVF, to be exact.

The almost 3 year old twins are now orphans, and her death again opened up that can of worms regarding fertility treatments and ethics.

Because the two are mutually exclusive, don't you know? Or at least, a large chunk of the population will have you think that way.

Fertility treatments and ethics are not mutually exclusive, however, they are also not black and white. Because we are dealing with lives, here. The lives of the parent(s), and the potential children. And just as in every day, regular life, there are a million gray areas.

The automatic knee jerk reaction to hearing a woman got pregnant at 66 thanks to IVF is often "they shouldn't do IVF on women that old!". I agree. I agree a woman of that age shouldn't get pregnant. I don't agree that it is the clinic's obligation to stop it. For what it's worth, the clinic did have an age limit - 55 - and she lied about her age. I also think 55 is too old. But that's my personal opinion. Again, I don't think the clinic should have to make those rules.

The reasoning behind not wanting to have a 66 year old woman do IVF and get pregnant is that she won't live long enough to raise her children. She'll die leaving them orphans at a young age. A reasonable fear. However, the gray area is this: say the clinic has a patient we'll name Emily. Emily is 29 years old and wants IVF because she has frozen embryos to transfer. She has embryos because her eggs were harvested and fertilized with her husband's sperm prior to her starting chemotherapy for an aggressive and often fatal form of cancer. It has been a couple years, and she appears to be in remission. Unfortunately, this particular cancer has a very high rate of recurrence within 5 years, and is terminal 75% of the time when it recurs. Chance of recurrence is about 60%. Long story short, the chance of Emily living longer than 5 years is less than 50%.

Should the clinic refuse her IVF because she may die in the nearer future?

If no, why is it different than refusing to treat women over a specific age?(barring of course the medical risks of a woman that age carrying a child, etc.,-we're only focusing on the GETTING pregnant part here).

To answer my question, I don't think the clinic should do IVF on a 66 year old woman, but I do think Emily deserves a chance. Totally doesn't make any sense, totally thinking with my heart and totally why it's clear to me that fertility treatments are not a black and white issue.

Do fertility clinics and reproductive endocrinologists have a moral obligation? In my opinion, yes, a moral obligation like any other doctor. But a moral obligation, or required to abide by a law of ethics that is unclear at

Fertility treatments are placed under fire all the time, more so than any other medical procedure because it's considered elective to many in the fertile community (most infertiles will tell you we didn't choose infertility and don't consider our treatments elective...believe me, there are a lot of ways I could have spent $20,000). In addition, the media only showcases the stories of the completely bat shit crazy freaks that do infertility treatments - like Octomom, and this old chick, Jon & Kate - the normal folks don't get the publicity so the perception is ridiculously skewed.

But stop and think for a minute before making assumptions. It's not that easy. It's not that cut and dry. It's not black and white. There are so many different stories, so many different circumstances that land us in the world of fertility treatments and the last thing we need piled on our plate is the questioning of our morals and ethics and those of the doctors trying to help us. Just because some crazy lady had 14 kids she can't afford or an old chick lied to a clinic and got pregnant at 66.


Jamers said...

Thank you for posting this. A million times, thank you. I couldn't agree with you more.

EmWed said...

I always learn from your posts about infertility and it's treatments. I really appreciate it.

EmWed said...

Ugh, its, not it's. Stupid autocorrect.

Sandy said...

I agree that it's not a black-and-white issue, and I get nervous when people start debating how old is too old to have a baby. I was 37 when I had my first son, and many people say you shouldn't have a baby after 35. What if they made THAT the cutoff? The problem with trying to pick an age is that it's a slippery slope toward telling women what they can and cannot do with their bodies.

I get angry when people say, "Oh, you'll be so old when Oscar graduates from high school, gets married, etc. SO WHAT? Life holds no guarantees, and if we both live to see those things, we are blessed. A young mom in her twenties could die at any time for any reason.

Aunt Becky said...

It's never black and white.

Excellent post, my friend.

Alison said...

Very interesting post Katie! I agree with you on all parts!